A patient’s metabolism could predict risk of depression relapse

It is estimated that more than 50 per cent of individuals with major depressive disorder experience a relapse of symptoms at some point in their life. Read to know why does depression reoccur.

Major depressive disorder (MDD), also known simply as depression, is a mood disorder characterised by multiple symptoms feelings of sadness or hopelessness, anger or frustration, loss of interest, sleep disturbances, anxiety, slowed or difficulty thinking, suicidal thoughts along with unexplained physical problems, such as back pain or headaches.

Depression is treatable with a combination of medication, therapy, and self-care, but relapses are also common. Many patients experience a relapse, either before recovery is complete or as a later, separate episode months or years after the first treatment. It is estimated that more than 50 per cent of individuals with major depressive disorder experience a relapse of symptoms at some point in their life.

Why does depression reoccur?

In many cases, depression may reoccur without any apparent reason. In other patients, a relapse may be triggered by a stressful life event (such as loss of a loved one, job change or financial struggles, or divorce), hormonal changes (such as during puberty, pregnancy or menopause) and discontinuing treatment for depression. According to a new study, a patient's metabolism may also play role in recurrent major depression.

The study, published in the journal Translational Psychiatry, suggested that certain metabolites -- small molecules produced by the process of metabolism -- may be the predictive indicators for persons at risk of recurrent major depressive disorder. The accuracy of this prediction is claimed to be more than 90 per cent.

"This is evidence for a mitochondrial nexus at the heart of depression. It's a small study, but it is the first to show the potential of using metabolic markers as predictive clinical indicators of patients at greatest risk -- and lower risk -- for recurring bouts of major depressive symptoms," said Robert K. Naviaux, a professor at University of California in San Diego, as quoted by IANS.

Changes in specific metabolites identified

For the study, the team collected blood samples from 68 subjects (45 females, 23 males) with recurrent major depressive disorder who were in antidepressant-free remission. The patients were followed prospectively for two-and-a-half years. They observed that a metabolic signature found when patients were well could predict who were most likely to relapse up to two-and-a-half years in the future.

According to them, the most predictive chemicals belong to certain kinds of lipids (fats that included eicosanoids and sphingolipids) and purines. Purines are made from molecules that are known to play a role in communications used by cells under stress, known as purinergic signaling.

Further, the researchers found that in subjects with recurrent depression, changes in specific metabolites in six identified metabolic pathways resulted in fundamental alterations of important cellular activities.

Watch out for the signs of a depression relapse

Depressive symptoms can vary among episodes. Therefore, it's important to be aware of the signs of a depression relapse so you can seek help early. Here are some warning signs of a depression relapse:

• Social withdrawal or avoiding social situations
• Loss of interest in things you once found pleasurable
• Trouble falling asleep or sleeping much more than usual
• Feeling sad or tearful with no known cause
• Lack of appetite
• Binge eating or loss of interest in exercise
• Feelings more irritable than usual
• Difficulty concentrating and focusing
• Restlessness or anxiety
• Feelings of worthlessness, guilt, or self-loathing
• Exhaustion and fatigue
• Unexplained aches and pains, stomach issues or headaches

Remember, seeking medical treatment as early as possible is the best way to cope with a relapse.